Editing Cholera (section)

=== Water, sanitation and hygiene ===
{{Further|WASH#Health aspects}}
Although cholera may be life-threatening, prevention of the disease is normally straightforward if proper [[sanitation]] practices are followed. In [[developed countries]], due to their nearly universal advanced [[water treatment]] and sanitation practices, cholera is rare. For example, the last major outbreak of cholera in the United States occurred in 1910–1911.<ref name="moltke1">{{cite news |title=CHOLERA KILLS BOY; EIGHTH DEATH HERE; All Other Suspected Cases Now in Quarantine and Show No Alarming Symptoms. |url=https://www.nytimes.com/1911/07/18/archives/cholera-kills-boy-eighth-death-here-all-other-suspected-cases-now.html |work=The New York Times |date=18 July 1911 }}</ref><ref name="moltke2">{{cite news |title=More Cholera in Port |url=https://pqasb.pqarchiver.com/washingtonpost_historical/access/250061412.html?dids=250061412:250061412&FMT=ABS&FMTS=ABS:FT&date=OCT+10%2C+1910&author=&pub=The+Washington+Post&desc=MORE+CHOLERA+IN+PORT&pqatl=google |quote=A case of cholera developed today in the steerage of the Hamburg-American liner [[SMS Moltke (1877)|Moltke]], which has been detained at quarantine as a possible cholera carrier since Monday last. Dr. A.H. Doty, health officer of the port, reported the case tonight with the additional information that another cholera patient from the Moltke is under treatment at [[Swinburne Island]]. |newspaper=[[The Washington Post]] |date=October 10, 1910 |access-date=2008-12-11 |url-status=dead |archive-url=https://web.archive.org/web/20081216072507/http://pqasb.pqarchiver.com/washingtonpost_historical/access/250061412.html?dids=250061412%3A250061412&FMT=ABS&FMTS=ABS%3AFT&date=OCT+10%2C+1910&author=&pub=The+Washington+Post&desc=MORE+CHOLERA+IN+PORT&pqatl=google |archive-date=December 16, 2008 }}</ref> Cholera is mainly a risk in [[Developing country|developing countries]] in those areas where access to [[WASH|WASH (water, sanitation and hygiene)]] infrastructure is still inadequate.

Effective sanitation practices, if instituted and adhered to in time, are usually sufficient to stop an epidemic. There are several points along the cholera transmission path at which its spread may be halted:<ref>{{Cite web|title=Cholera|url=https://www.who.int/news-room/fact-sheets/detail/cholera|access-date=2020-08-20|website=www.who.int|language=en}}</ref>
* Sterilization: Proper disposal and treatment of all materials that may have come into contact with the feces of other people with cholera (e.g., clothing, bedding, etc.) are essential. These should be [[Disinfection|sanitized]] by washing in hot water, using [[chlorine]] [[bleach]] if possible. Hands that touch cholera patients or their clothing, bedding, etc., should be thoroughly cleaned and disinfected with chlorinated water or other effective antimicrobial agents.
* [[Sewage]] and [[fecal sludge management]]: In cholera-affected areas, sewage and fecal sludge need to be treated and managed carefully in order to stop the spread of this disease via [[human excreta]]. Provision of [[sanitation]] and [[hygiene]] is an important preventative measure.<ref name="who.int" /> [[Open defecation]], release of untreated sewage, or dumping of fecal sludge from [[pit latrine]]s or [[septic tank]]s into the environment need to be prevented.<ref>{{Cite book|url=https://books.google.com/books?id=AGQVBeNM_80C&pg=PA5|title=Urban Water Security: Managing Risks: UNESCO-IHP|last1=Cisneros|first1=Blanca Jimenez|last2=Rose|first2=Joan B. |date=2009-03-24|publisher=CRC Press|isbn=978-0-203-88162-0|language=en}}</ref> In many cholera affected zones, there is a low degree of [[sewage treatment]].<ref>{{Cite book|url=https://books.google.com/books?id=rd3zCAAAQBAJ&pg=GBS.PA24|title=Cholera and the Ecology of Vibrio cholerae| vauthors = Drasar BS, Forrest DB  |date=2012-12-06|publisher=Springer Science & Business Media|isbn=978-94-009-1515-2|page=24}}</ref><ref>{{Cite book|url=https://books.google.com/books?id=dAT9CgAAQBAJ&pg=PA219|title=A Companion to the Anthropology of Environmental Health|last=Singer|first=Merrill  |date=2016-05-31|publisher=John Wiley & Sons|isbn=978-1-118-78699-4|page=219}}</ref> Therefore, the implementation of [[dry toilet]]s that do not contribute to [[water pollution]], as they do not flush with water, may be an interesting alternative to [[flush toilet]]s.<ref>{{cite news |last1=Gili |first1=Enrique |date=9 June 2015 |title=Starting a poop to compost movement |url=https://www.dw.com/en/global-ideas-haiti-poop-compost-toilets/a-18504469 |work=Deutsche Welle }}</ref>
* Sources: Warnings about possible cholera contamination should be posted around contaminated water sources with directions on how to [[decontamination|decontaminate]] the water (boiling, chlorination etc.) for possible use.
* [[Water purification]]: All water used for drinking, washing, or cooking should be sterilized by either boiling, [[Water chlorination|chlorination]], ozone water treatment, ultraviolet light sterilization (e.g., by [[solar water disinfection]]), or antimicrobial filtration in any area where cholera may be present. Chlorination and boiling are often the least expensive and most effective means of halting transmission. [[Cloth filter]]s or [[#Sari filtration|sari filtration]], though very basic, have significantly reduced the occurrence of cholera when used in poor villages in [[Bangladesh]] that rely on untreated surface water. Better antimicrobial filters, like those present in advanced individual water treatment hiking kits, are most effective. Public health education and adherence to appropriate sanitation practices are of primary importance to help prevent and control transmission of cholera and other diseases.

[[Hand washing|Handwashing]] with soap or ash after using a [[toilet]] and before handling food or eating is also recommended for cholera prevention by WHO Africa.<ref>{{cite web |title=Cholera and food safety |url=http://who.insomnation.com/sites/default/files/pdf/fan_cholera%20fact%20sheet7.pdf |publisher=[[World Health Organization]] |access-date=2017-08-20 |url-status=dead |archive-url=https://web.archive.org/web/20170821044840/http://who.insomnation.com/sites/default/files/pdf/fan_cholera%20fact%20sheet7.pdf |archive-date=2017-08-21 }}</ref>

<gallery class="center" widths="225px" heights="200px">
File:Unsafe disposal of faecal sludge or sewage in Haiti (6458176073).jpg|Dumping of [[sewage]] or [[Fecal sludge management|fecal sludge]] from a UN camp into a lake in the surroundings of [[Port-au-Prince]] is thought to have contributed to the spread of [[2010 Haiti cholera outbreak|cholera after the Haiti earthquake in 2010]], killing thousands.
File:A SOIL EkoLakay toilet customer. (15921409131).jpg|Example of a [[urine-diverting dry toilet]] in a cholera-affected area in [[Haiti]]. This type of toilet stops transmission of disease via the [[Fecal–oral route|fecal-oral route]] due to [[water pollution]].
File:Cholera hospital in Dhaka.jpg|[[International Centre for Diarrhoeal Disease Research, Bangladesh|Cholera hospital]] in [[Dhaka]], showing typical "cholera beds"
</gallery>